Current opinion in hematology
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Curr. Opin. Hematol. · May 2011
ReviewEndothelial activation and dysregulation in malaria: a potential target for novel therapeutics.
Despite parenteral artesunate therapy, the fatality rate of cerebral malaria remains high. Adjunctive therapy targeting the underlying pathophysiology of cerebral malaria may further improve the clinical outcome. Endothelial activation and dysfunction is a central process in the pathogenesis of cerebral malaria. An improved understanding of how endothelium is perturbed in cerebral malaria may yield novel strategies to diagnose and intervene. Here, we discuss recent findings on the key molecular mediators of endothelial activation/dysregulation in cerebral malaria, and innovative endothelial-based experimental approaches to improve detection and treatment. ⋯ Interventions targeting the Ang-Tie-2 axis to promote endothelial quiescence, including agents to improve endothelial nitric oxide, represent potential adjunctive therapies for cerebral malaria.
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Curr. Opin. Hematol. · Jan 2011
ReviewNeutrophil gelatinase-associated lipocalin as a marker of acute renal disease.
Acute renal disease has major prognostic impact in hospitalized patients. Early diagnosis using renal function markers such as serum creatinine or urinary output and effective treatment are currently not possible. This review focuses on recent studies examining the biological characteristics and the diagnostic and prognostic value of a novel biomarker, neutrophil gelatinase-associated lipocalin (NGAL), in patients at risk for acute renal disease. ⋯ NGAL fulfills many characteristics of an appropriate 'real-time' renal biomarker. The data on NGAL could justify re-assessment of the concept and definition of acute kidney injury.
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Curr. Opin. Hematol. · Nov 2010
ReviewAnalysis and clinical relevance of microparticles from red blood cells.
The mechanisms involved in the formation of red blood cell (RBC) microparticles in vivo as well as during erythrocyte storage are reviewed, and the potential role of microparticles in transfusion medicine is described. ⋯ Formation and role of RBC microparticles are far from being completely understood. Combining various approaches to elucidate these mechanisms could improve blood product quality and transfusion safety. Implementation of RBC microparticles as biomarkers in the laboratory routine needs to overcome technical barriers involved in their analysis.
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The purpose of this review is to summarize the recent experimental and clinical literature on the pathogenesis of transfusion-related acute lung injury (TRALI). ⋯ TRALI requires an immune priming step followed by transfusion of a blood product with either leukocyte allo-antibodies or biological response modifiers. TRALI invokes an acute immune response dominated by neutrophils interacting with platelets and the lung endothelium.
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Curr. Opin. Hematol. · Sep 2010
ReviewPreclinical and clinical progress in hemophilia gene therapy.
Hemophilia A and B are attractive target diseases for gene therapy, as stable expression of coagulation factor VIII and IX may correct the bleeding diathesis. This review focuses on the recent progress in preclinical and clinical studies in gene therapy for hemophilia A and B. ⋯ New insights from clinical trials and advances in preclinical studies may ultimately pave the way toward a cure in patients suffering from hemophilia.